Despite impassioned protests, Los Angeles County supervisors voted Tuesday to close the trauma center at Martin Luther King Jr./Drew Medical Center, saying the unit had to be sacrificed as part of a larger strategy to save the troubled hospital.

The decision marks the strongest action yet by county officials to reform King/Drew, where medical lapses have been tied to the deaths of several patients and now threaten the hospital's accreditation and federal funding.

The King/Drew trauma center in Willowbrook, just south of Watts, serves the most violence-prone neighborhoods in the county, and is credited with saving the lives of countless victims of gunshots, stabbings and serious traffic accidents.

County health officials said, however, that because trauma victims required such intense care, the unit was putting too much of a strain on the rest of the hospital.

"These actions truly are the first step in a long road to restore medical standards and excellence to the hospital," said Supervisor Mike Antonovich. "Right now, anyone being treated there is being treated at a danger to their health and their life."

The five-member Board of Supervisors voted 4 to 0 for the closure, with Supervisor Yvonne Brathwaite Burke abstaining. The board cushioned the blow by approving an amendment by Burke — who represents the South Los Angeles area where the county-run hospital is located — committing the county to a goal of eventually reopening the trauma center.

"It's not a good day," Burke said after the vote, "but the reality is that we can't ignore that we have problems at the hospital. We have to do something. And we're doing something."

Under the plan, King/Drew's emergency room — a separate department that treats a wider range of ailments — will remain open.

Many of the patients who would have been treated at King/Drew's trauma center will now be sent to a new trauma unit at the private California Hospital Medical Center in downtown Los Angeles. That unit, subsidized by the county, is scheduled to open Dec. 1.

King/Drew would begin to phase out its trauma unit at that point but could continue to take patients until Feb. 1, county officials said.

After that, all the patients who would have gone to King/Drew will be sent to one of three hospitals: California Hospital, St. Francis Medical Center in Lynwood and Harbor-UCLA Medical Center near Torrance.

The trauma center closure has ignited protests and widespread opposition in the area served by King/Drew. County supervisors heard more than six hours of testimony from community members and local political leaders last week, all of it opposed to the closure. They heard more opposition on Tuesday from some of the crowd of more than 200 that turned out for the meeting in the county Hall of Administration.

"We trusted you and you have let us down," said one speaker, Nelle W. Ivory. "I don't feel that you're trying to solve the problem."

Community activist Sheliah Ward said the Rev. Martin Luther King Jr. "would be turning over in his grave" if he knew what was happening to the hospital built in his name.

But the opposition was more muted than in past meetings, and leaders of the movement to save the trauma center seemed resigned. U.S. Rep. Maxine Waters (D-Los Angeles), who helped organize much of the opposition, was unusually conciliatory in remarks to the board. She said afterward that she considered the outcome a victory, because the supervisors said they would try to reopen the trauma unit as soon as possible.

"It will not be shut down; it will just be suspended," Waters told reporters after the meeting. "I think we've had something of a win."

Although both Waters and Burke referred to the action as a suspension, not a closure, the head of the county's Emergency Medical Services Agency said hospital regulations make no such distinction. Carol Meyer, whose agency oversees the county's trauma network, said the unit will be closed, and the county will have to reapply to restore its trauma designation if and when it reopens.

Neither the supervisors nor the county's health chief, Dr. Thomas Garthwaite, were clear about when the unit might reopen. Garthwaite said he hoped the hospital would be sufficiently improved in one year to reassess whether it could support a trauma unit.

Burke held out hope that it could be reopened sooner than that. She asked that a consulting firm that the county hired to run the hospital be asked to conduct "ongoing assessments" of whether King/Drew can safely provide trauma services.

"It's very important," she said. "We have to give direction to the Department of Health Services that it's closed only temporarily — suspended," she said.

Had it been politically feasible, she said, she would have sided with other compromise proposals, such as one drafted by Los Angeles City Councilman Martin Ludlow to reduce the load on the trauma center without closing it.

"I think that would have been excellent," Burke said, "but I don't think that there were votes for this approach."

In testimony to the board, Ludlow and other elected officials, including Waters, City Councilman Antonio Villaraigosa and Rep. Juanita Millender-McDonald (D-Carson), all urged the board to hire more nurses at the hospital, saying that measure — not closing the trauma center — would solve its primary problems.

"There's no way that we can have quality healthcare when over 200 nursing slots have not been filled," Millender-McDonald said.

But board members were not swayed by that argument.

Nor were they deterred by protests. Board members have said in the past that they have been intimidated by pressure from the community surrounding the hospital. There have been racial overtones to some of that pressure, reflecting King/Drew's history as an institution built in response to the 1965 Watts riots and run primarily by African Americans.

Supervisor Zev Yaroslavsky acknowledged the board's failures Tuesday, saying the supervisors had been reluctant in the past to even talk about problems at King/Drew.

"This is the first time since I've been on the board when there has been an honest, if not painful, discussion about what's going on at that hospital," he said, "and it's long overdue."

Yaroslavsky, who voted to close the unit along with Antonovich and Supervisors Don Knabe and Gloria Molina, added that the board's objective now was "to restore this hospital to a level of service, a quality of service, that is not just standard — I hope better than standard . It isn't that way now, and we've got to fix it."

"But it's your fault!" yelled someone in the audience.

Although there were outbursts from the crowd throughout the meeting — and it ended with chants of "Save King/Drew!" giving way to "No justice, no peace!" — there was little of the surging sense of excitement that pervaded last week's marathon hearing.

Celes King IV, vice chairman of the California Congress of Racial Equality, said that many in the crowd realized they had little chance of persuading the board to keep the trauma center open, but felt that the issue was too important to stay away.

"We're making a statement," he said. "We're still here. We're going to fight. Because people are going to die because of this decision."

He said that immediately after the vote he would contact lawyers who have already sued the county over the planned shutdown. Doctors at the hospital and community activists intended to ask a judge to halt the closure while the suit progressed, he said.

As the crowd filed out of the auditorium at the end of Tuesday's meeting, Mollie Bell, a Compton postal worker, turned to the disheartened residents.